Monday, August 3, 2009

Detour / The Space Between

[Photo by Brian Stansberry.]

It was supposed to be a routine pre-op visit. An opportunity to make sure he'd be ready for surgery.

There would be the usual round of questions: Do you have any allergies?...Have you had any trouble with anesthesia in the past?...Do you get short of breath when you climb stairs?...I need to examine the inside of your mouth. Could you open wide for me please and stick out your tongue?

He, in turn, would ask me about the anesthetic plan. I would get his signature on a consent form. We might make some small talk about past hospital visits, family, work, local restaurants. I'd make sure all the labs and paperwork were in the chart. Then I'd move on to the next patient I had to see on rounds.

But at the end of the visit, during the small talk part, as we were winding down, dotting our i's, crossing our t's, something happened. Perhaps a wave of dread over the impending procedure came over him. Perhaps the loneliness of being imprisoned there, alone, in an edifice filled with sick people, of whom he was one, finally cracked open his already wounded heart and released a rush of emotions. This patient, whom I had never met before and whom I would probably never see again (because someone else would be providing his anesthesia the next morning), began to cry.

"I lost my partner last spring," he said.

"I'm so sorry," I said.

A tear escaped down the side of his face. I took a tissue out of a small box at the bedside and dabbed at the corner of his eye.

He told me a little about their relationship. How they had been married to others earlier in life, then had found one another and been together for decades. How they had held hands in the end, while the pain medicine was running, and how when death finally arrived, his partner's hand simply went limp in his. Another tear rolled down his cheek. I took his hand in mine, and his grasp was tight, as if he might never let me go.

"Your partner didn't die alone. That's a blessing."

The patient nodded, then began to sob quietly.

We talked a little more about his loved one, and about the day ahead. At the end of our conversation I squeezed his hand and said, "Have no fear."

"No fear," he repeated with a shake of his head, willing negative thoughts away.

"You won't be alone tomorrow."

He thanked me and gave me a compliment, then let go of my hand. I returned to the nurses' station and put his chart back on the shelf. It stood in a row of a dozen others exactly like it, now almost indistinguishable from them, anonymous. A collection of data. History, but no story.

I pulled out the chart for the next patient and resumed the night's work.


Isabelle said...

What a beautiful post!
This patient was lucky enough that you cared for him... I'm sure that most people would have walked away with embarrassment.

rlbates said...

I get "detours" like this when talking to patients too, but you are able to put them into words. Nicely done.

Kim said...

This is a good post. Thanks for sharing it.

T. said...

Thanks, all - I find it's "detours" like these that actually help keep me on the right track.

OMDG said...

Being able to connect with patients in the way you describe is (for me) far and away the best part of being an (almost) doctor. Thank you so much for sharing this story.